Dr John Clark Nelson, MD is a medicare enrolled "Obstetrics & Gynecology - Gynecology" physician in Centerville, Utah. His current practice location is
330 Paradiso Ln, Centerville, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 580-3523.
Dr John Clark Nelson is licensed to practice in Utah (license number 151881-1205) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1073776787.
Physician's Profile
| Full Name | Dr John Clark Nelson |
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| Gender | Male |
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| Speciality | Obstetrics & Gynecology - Gynecology |
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| Location | 330 Paradiso Ln, Centerville, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1073776787
- Provider Enumeration Date: 07/03/2008
- Last Update Date: 07/03/2008
Medicare PECOS Information:
- PECOS PAC ID: 3173585718
- Enrollment ID: I20041027000434
Medical Identifiers
Medical identifiers for Dr John Clark Nelson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1073776787 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207VG0400X | Obstetrics & Gynecology - Gynecology | 151881-1205 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr John Clark Nelson allows following entities to bill medicare on his behalf.
| Entity Name | State Of Utah |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811978620 PECOS PAC ID: 6800797333 Enrollment ID: O20040117000195 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr John Clark Nelson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr John Clark Nelson, MD 330 Paradiso Ln, Centerville, UT 84014-2826 Ph: (801) 580-3523 | Dr John Clark Nelson, MD 330 Paradiso Ln, Centerville, UT 84014-2826 Ph: (801) 580-3523 |
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